HOW WELL DO PATIENTS TAKE ORAL PENICILLIN? A COLLABORATIVE STUDY IN PRIVATE PRACTICE

TLDR

The study examined which factors predict adherence to oral penicillin therapy in children. Researchers measured penicillin compliance in 459 children from three private pediatric practices by detecting the drug in urine with the Sarcina lutea culture method at five and nine days of treatment. Compliance was high on day five (81%) but fell to 56% by day nine, with 13% erratic takers; children with pharyngitis were more likely to finish therapy, while adherence was unrelated to age, sex, symptom duration, or physician severity estimates but correlated with mothers’ perceived severity, their usual doctor’s prescription, and certain maternal personality traits.

Abstract

A study of how well children took oral penicillin when prescribed for streptococcal pharyngitis or otitis media was conducted in three private pediatric group practices. The presence of penicillin in the urine, as determined by the Sarcina lutea culture method, was used to assess the compliance rate. A total of 459 patients were studied—107 at five days of therapy and 352 at nine days. Eighty-one percent of the patients were taking the penicillin as prescribed on the fifth day, and 56% were taking it on the ninth day. Another 13% were erratic takers at the end of therapy. The children with pharyngitis were somewhat more likely to complete therapy than those with otitis media. A number of factors were studied in an attempt to differentiate those who complied with the therapy from those who did not. The take rate was unrelated to age or sex of the child, duration of symptoms, or doctor's estimate of severity of disease at onset. It was correlated with mother's estimate of severity, whether or not their usual doctor prescribed the medicine, and certain personality traits of the mother as perceived by the pediatrician. The implications of the study for the use of oral therapy in children are discussed.